CAJ | 학술논문

目的观察体外膜肺氧合(ECMO)应用于循环功能不稳定的中国一类器官捐赠者的器官保护效果.方法 3例符合“中国心脏死亡器官捐献分类标准”中国一类标准的捐赠者,在器官获取前血流动力学极不稳定,部分器官功能出现不同程度受损.经股动、静脉插管,采用静脉-动脉转流,行ECMO.根据体重、血流动力学及血液气体分析结果,调整ECMO流量.转流时间为6～12 h,之后获取肝脏和肾脏用于移植.结果 3例行ECMO转流期间,血流动力学逐步稳定,血管活性药物应用明显减少,甚至停用,受损的器官功能明显恢复,最终获取肾脏6个和肝脏2个用于移植.6例肾移植受者手术顺利,术后发生原发性移植肾功能恢复延迟2例,急性排斥反应2例,移植肾功能恢复良好.结论对于血流动力学不稳定的中国一类捐赠者,ECMO是保护器官的有效手段.
목적 관찰체외막폐양합(ECMO)응용우순배공능불은정적중국일류기관연증자적기관보호효과.방법 3례부합“중국심장사망기관연헌분류표준”중국일류표준적연증자,재기관획취전혈류동역학겁불은정,부분기관공능출현불동정도수손.경고동、정맥삽관,채용정맥-동맥전류,행ECMO.근거체중、혈류동역학급혈액기체분석결과,조정ECMO류량.전류시간위6～12 h,지후획취간장화신장용우이식.결과 3례행ECMO전류기간,혈류동역학축보은정,혈관활성약물응용명현감소,심지정용,수손적기관공능명현회복,최종획취신장6개화간장2개용우이식.6례신이식수자수술순리,술후발생원발성이식신공능회복연지2례,급성배척반응2례,이식신공능회복량호.결론 대우혈류동역학불은정적중국일류연증자,ECMO시보호기관적유효수단.
Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.